Endocrine Abstracts

Background: Despite new, albeit draft, international guidelines there remains limited data and guidance on the non-cardiac obstetric management and outcomes in women with Turner Syndrome (TS).

AIMS: This retrospective single centre audit aimed to assess the maternal and fetal outcomes in a large single centre cohort.

METHODS: We identified 110 women under our care with TS. Of these, 28 women had attempted to achieve a pregnancy. Clinical data was correlated with birth registration records.

RESULTS: 12/28 achieved a pregnancy using assisted reproductive techniques (ART), the other 16/28 achieved spontaneous conception (SP), 22 seperate pregnancies. Of those undergoing ART, 6/12 went on to have live births, including a set of twins. The genotype 45XO was expressed in 2/6 of the ART group; 4/6 expressed mosaicisms. Maternal age ranged from 31-40. There was no information available regarding frequency of donor oocytes. Pre-existing hypertension was present in 3/6, and there was no evidence of progression to pre-eclampsia. Gestational diabetes developed in 2/6, one of whom went on to develop Type 2 Diabetes.

Of the 16 who experienced SP, one woman expressed a 45XO genotype; 15 expressed mosaicisms. Full obstetric information was available on 6 of the SP maternities. There were 3 elective caesarean sections for obstetric indications and 3 operative vaginal deliveries. One woman developed gestational hypertension, and then pre-eclampsia in a subsequent pregnancy. One was known to have subclinical thyroid disease, but no new cases in pregnancy. No women developed gestational diabetes, obstetric cholestasis or acute cardiac problems. All 6 babies had a birth weight above the 10^th centile.

Conclusions: Although pregnancy rates were low, outcomes were good. Accepting the increased risk of cardiac complications, perhaps it is time to reconsider our counselling of these women, in order to provide a more reassuring advice within the appropriate Multi Disciplinary Team setting.